Wiese, C. H. R. and Bartels, U. E. and Ruppert, D. B. and Graf, B. M. and Hanekop, G. G. (2011) Prehospital emergency physicians' experiences with advance directives in Germany: A questionnaire-based multicenter study. MINERVA ANESTESIOLOGICA, 77 (2). pp. 172-179. ISSN 0375-9393,
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Background. Palliative medical emergencies and end-of-life decisions resulting from the exacerbation of cancer account for approximately 3% of all out-of-hospital emergency applications in Germany. Therefore, prehospital emergency physicians (EP) may be confronted with advance directives and ethical and end-of-life decisions. The purpose of the study was to identify, EPs' knowledge about ethical and end-of-life decisions and their legal education and experiences concerning advance directives. Methods. Over a six-month period, we questioned all 150 EPs from three emergency medical services (Braunschweig, Gottingen und Kaiserslautern). An anonymous, self-administered questionnaire with a mixed-methods design was used. The main outcome measures included responses regarding experiences related to advance directives and end-of-life decisions in palliative care patients. For statistical assessment, EPs were divided into three categories: competent, skilled, and unskilled. Results. A total of 104 EPs returned the questionnaire (response rate 69%). Eighty-nine percent of the respondents treated patients who had advance directives. The existence of an advance directive influenced the EP's therapy decision in about 77% of their encounters. Eighty-seven percent of the EPs reported the need for defined end-of-life care pathways and/or standard operating procedures. Eighty-two percent desired educational training concerning end-of-life decisions and the validity of advance directives. Conclusion. The prehospital emergency treatment of palliative care patients can be particularly challenging for any ER A high percentage of the EPs in our study felt insecure in dealing with advance directives and ethical and end-of-life decisions in palliative care patients. Our results suggest that EPs may need more information and education about palliative medical care, legal issues and ethical and end-of-life decisions to provide adequate patient-oriented palliative care in prehospital emergency situations. (Minerva Anestesiol 2011;77:172-9)
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ILL CANCER-PATIENTS; CARDIOPULMONARY-RESUSCITATION; DECISION-MAKING; ETHICAL-ISSUES; CARE; MEDICINE; PATIENT; ORDER; Emergency medicine; Palliative care; Advance directives |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 26 Jun 2020 06:13 |
| Last Modified: | 26 Jun 2020 06:13 |
| URI: | https://pred.uni-regensburg.de/id/eprint/21292 |
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